Bicornuate uterus

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[edit] Discussion of Bicornuate uterus

  • The bicornuate uterus results from incomplete fusion of the uterovaginal horns at the level of the fundus
  • Accounts for approximately 10% of müllerian duct anomalies.
  • A bicornuate uterus consists of two symmetric cornua that are fused caudad, with communication of the endometrial cavities.
    • The intervening cleft of the complete bicornuate uterus extends to the internal cervical os (bicornuate unicollis)
    • The cleft of a partial bicornuate configuration is of variable length.
    • A bicornuate bicollis uterus is associated with a duplicated cervix, although a degree of communication is maintained between the two horns.

  • Surgical intervention is usually not indicated.
  • Strassman metroplasty has been advocated in women with a history of recurrent pregnancy loss and in whom no other infertility issues have been identified
  • The bicornuate uterus has been reported to have the highest associated prevalence (38%) of cervical incompetence among müllerian duct anomalies and prophylactic placement of a cervical cerclage in selected patients has been reported to increase fetal survival rates.

[edit] Imaging Findings for Bicornuate uterus

[edit] HSG

  • The horns of the endometrial cavity are usually widely separated with an intercornual angle greater than 105°.
  • Each horn has a fusiform appearance, with apices that taper and end in a single fallopian tube.
  • Radiographic appearance has such a large degree of overlap with that of the septate uterus and differentiation from the septate uterus often not possible.

[edit] US

  • A large fundal cleft with divergence of the uterine horns and associated echogenic endometrial complexes.

[edit] MRI

  • MRI demonstrates a cleft of at least 1.0 cm of the external fundal uterine contour.
  • The horns demonstrate normal uterine zonal anatomy.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Bicornuate uterus